Much has been written about the disproportionately high incidence of health problems such as diabetes and obesity among African Americans and Latinos when compared to non-Hispanic whites. But health disparities among smaller minority groups such as American Indians and Pacific Islanders have received far less attention.

A new report out of University of California Riverside aims to change that. Led by Andrew Subica, an assistant professor of social medicine, population and public health, the study examines seven years worth of data on health trends among American Indians and Alaskan natives, native Hawaiians and other Pacific Islanders and multiracial adults living in California.

The findings paint a startling picture of ill health among these small and historically neglected populations. Not only do their rates of diabetes and obesity surpass those of non-Hispanic white people, but many are just as or even more likely to suffer from these diseases than African Americans and Latinos.

“We need to start paying more attention to these groups. We need to start dedicating more resources, health care,” said Subica. “My paper’s purpose is to highlight these groups and that they actually do have some poor health, and to build awareness and more research and clinical attention, otherwise these health disparities aren’t going to change.”

To conduct the study, Subica and his colleagues analyzed multiple years of data from the California Health Interview Survey, a biennial randomized phone survey of more than 20,000 Californians. Subica said the survey is one of the best sources of health data on smaller racial minorities and multiracial people, who are often overlooked or merged with other racial categories in health studies.

The researchers found that multiracial, Native Hawaiian and Other Pacific Islanders, and American Indian and Native Alaskans are up to twice as likely to suffer from obesity and diabetes as non-Hispanic whites.

American Indians fared particularly poorly, with higher rates of diabetes, obesity, self-reported subpar health status and physical disability than any other racial category. Pacific Islanders, meanwhile, had similar obesity and diabetes rates – about 30 percent and 10 percent respectively – as Latinos.

Subica and his team also examined factors that can contribute to ill health, such as poverty, lack of education, marital status and access to health insurance. Again, the smallest minority groups fared worse on these than white, non-Hispanic Californians. Nevertheless, even accounting for these factors couldn’t fully explain the health disparities, Subica said.

The professor suggested other, less quantifiable factors might be influencing the health of these minorities. Specifically, the toll of racism and – for Native Americans, Alaskans and Hawaiians – the historical trauma wrought by colonization and conquest. Multiracial individuals, meanwhile, may also struggle with social rejection and internal conflict over their identity, he said.

Melissa Deer, chief medical officer at the San Diego American Indian Health Center, said scientists are only just beginning to understand the impact of past trauma and historical stress on family genetics. She said Native Americans continue to suffer the repercussions of past displacement and conflict, together with present-day marginalization and poverty, all of which impacts their physical and mental health.

“Our community still experiences a high degree of personal trauma and structural racism that’s been institutionalized from our trauma history in this country,” she said.